When to See a Doctor About Congestion

Signs of Trouble You Should Watch Out For

In This Article

A runny or stuffy nose is something you might chalk up to allergies or the common cold and try to manage with at-home treatments or medications that usually work for you. But you can also develop nasal congestion for other reasons, such as the flu and other upper respiratory infections, that may require medical care to manage both the illness and your risk of complications.

Often, people are unsure when they should see a doctor for their nasal congestion and put off making an appointment until a minor condition suddenly turns serious. For example, someone may think they just have a nasty cold when it's actually the flu, an illness that causes anywhere from 12,000 to 61,000 deaths in the U.S. each year.

Certainly, nasal congestion isn't always a cause for concern. It could be a sign of a minor cold or point to seasonal allergies. However, if you experience these symptoms or circumstances along with it, it could be a potentially serious condition:

  • Severe cold or flu symptoms in someone over 65
  • Symptoms that worsen after five days or persist for more than 10 days
  • A temperature of 100.4 degrees F
  • Trouble breathing or chest pains
  • A sore throat and pain with swallowing
  • A persistent cough that's either hacking or productive (bringing up phlegm or mucus)
  • Nasal discharge that's yellow or green (a sign of a sinus infection)
  • Severe sinus pain

Additional warning signs in a young child are:

  • Severe cold or flu symptoms
  • A fever (age 2 or younger)
  • Difficulty breathing or feeding
  • Inability to keep down food or liquid

Read on for more information and see your doctor if any of these apply, or if your nasal congestion simply won't improve. Finding relief means getting to the root of the symptom.

Severe Cold/Flu Symptoms After 65

People 65 and older are at high risk of serious complications from the flu. The Centers for Disease Control and Prevention (CDC) says that between 70% and 85% of deaths from the flu are in this age group.

The flu can be hard to distinguish from a cold or numerous other illnesses with similar symptoms, so it's best to get checked out any time you develop severe respiratory symptoms.

Symptoms to watch for include:

  • Fever
  • Headache
  • Cough
  • Severe muscle aches
  • Extreme fatigue

If left untreated, flu complications can lead to bronchitis and pneumonia, which cause hospitalizations and deaths every year.

Worsening or Persistent Symptoms

By definition, the common cold, which doctors call viral rhinosinusitis, has symptoms that last for 10 days or less. It doesn't require medical treatment, as it'll go away on its own.

Nonviral rhinosinusitis, on the other hand, has symptoms that increase after five days or persist for more than 10 days. Not only will it not resolve on its own, it can lead to complications if you don't get treatment, including:

  • Periorbital cellulitis (an infection of the eyelid or the skin around the eye)
  • Forehead swelling
  • Double vision

If you doctor diagnoses nonviral (or bacterial) rhinosinusitis, they'll probably prescribe antibiotics and possibly steroid nasal spray. If you already have complications, you'll likely get an urgent referral to an ear, nose, and throat (ENT) specialist.

100.4-Degree Fever

A temperature of 100.4 degrees F is the official threshold for a fever. Fevers are part of your body's natural response to illness and, as long as they stay relatively low, aren't a problem in and of themselves for most people. (A temperature over 104 degrees does warrant medical attention, though.)

When you have a fever along with congestion, it can be a sign of the flu or a severe sinus infection. You may need medical treatment to get better and avoid serious complications.

Trouble Breathing and Chest Pains

When congestion is accompanied by any of the following, consider it an emergency warning sign of the flu:

  • Difficulty breathing
  • Shortness of breath
  • Persistent chest pain
  • Pressure in the chest

If you're experiencing these symptoms, you need treatment as soon as possible. Call your doctor or get emergency medical help.

Sore Throat/Pain With Swallowing

When alongside congestion, a sore throat and pain when you swallow can be a sign of sinus infection, flu, strep throat, or other serious respiratory symptoms.

A sore throat that's like a tickle and makes you cough or clear your throat can be the result of sinus congestion draining down the back of your throat, a.k.a. post-nasal drip. That's not necessarily something to worry about unless it's happening a lot. Then, it could be related to a sinus infection or other potentially serious problem, so it's worth seeing your doctor.

Hacking or Productive Cough

A cough is your body's way of moving mucous. You should take a cough seriously when:

  • It causes a hacking or whooping sound
  • Brings up mucus or phlegm (a productive cough)
  • Doesn't go away with the cold, flu, or other acute illness that brought in on

Possible causes of a serious or persistent cough include bronchitis, pneumonia, and whooping cough.

Yellow or Green Nasal Discharge

It's normal for your snot to turn yellow or green a few days into a cold. That alone isn't indicative of a problem.

However, discolored nasal discharge may point to something more serious if it:

  • Persists for more than two weeks
  • Accompanies a fever
  • Accompanies a cough

These could be signs of nonviral rhinosinusitis, a sinus infection, or other illness that needs to be treated with antibiotics.

Severe Sinus Pain

Congestion can cause inflammation in the sinuses, or it can trap bacteria, allowing it to multiply and start an infection. This is called sinusitis, one of the chief symptoms of which is pain.

Sinus pain can occur in a few different places, depending on where the inflammation is, including:

  • Behind your forehead
  • Behind the bridge of your nose
  • Under, between or behind your eyes
  • In your ears
  • At the top of your head
  • Behind your cheeks
  • In your upper teeth and jaw

Sinusitis can be the result of multiple factors that irritate the sinuses, including viral infection, allergies, and air pollution.

Some cases of sinusitis get better on their own, but you may need antibiotics and/or a nasal steroid spray to get better.

It's possible for seasonal allergies to cause severe sinus pain, as well. People who are prone to these allergies will often suffer silently, believing that the seasonal effects are something they have to live with.

However, if symptoms seem worse than they have in the past, it may be time to see your doctor or allergist for help finding better treatments. It's time to make the call when:

  • You've tried different over-the-counter medications and still need relief
  • You have recurrent or persistent sinus infections, ear infections, or headaches
  • Symptoms last for more than two months
  • Symptoms are interfering with your sleep

Seasonal Allergies Doctor Discussion Guide

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Disease burden of influenza. Updated January 10, 2020.

  2. Centers for Disease Control and Prevention. People 65 Years and Older & Influenza. Updated November 21, 2019.

  3. Centers for Disease Control and Prevention. Key Facts About Seasonal Flu Vaccine. Updated December 2, 2019.

  4. Bird J, Biggs TC, Thomas M, Salib RJ. Adult acute rhinosinusitisBMJ. 2013;346:f2687. doi:10.1136/bmj.f2687

  5. Centers for Disease Control and Prevention. Sore throat. Updated August 30, 2019.

  6. Harvard Medical School, Harvard Health Publishing. Treatments for post-nasal drip. Updated February 6, 2020.

  7. Cleveland Clinic. What Does Your Cough Say About Your Illness? 2018.

  8. Harvard Medical School, Harvard Health Publishing. Acute Sinusitis. 2019.

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